Morbidly adherent placenta previa: clinical course and risk from emergency delivery in a series of 26 women that underwent hysterectomy

Objectives: A retrospective review of morbidly adherent placenta previa (MAPP) to assess its clinical course and risk from emergency delivery. Study design: Data of all placenta previa (PP) delivered in this hospital over a period of >ten years were obtained from hospital register. Results: 91 women included, 26 MAPP and 65 PP. Emergent delivery and delivery for hemorrhage were significantly lower in MAPP (p = 0.033 and 0.046 respectively). In those beyond 35 weeks, one MAPP and 16 PP needed emergent delivery (p = 0.015). MAPP who needed emergent delivery had higher rate of bleeding during pregnancy and bleeding before 32 weeks (p=0.034 and 0.01 respectively). Complications rate in MAPP were similar in emergency and elective delivery but for postoperative hospital stay (p = 0.042). All neonates delivered at <= 34 weeks and two out of six delivered at 35-36 weeks and admitted to NICU. Conclusion: The authors conclude that in this study group majority of MAPP were stable and emergent deliveries had more frequent history of bleeding before 32 weeks. Timing of delivery should take into consideration history of bleeding and availability of NICU resources in stable patients.